Ohio
Provider Communications

Articles

Title Publication Category Date

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Anthem Provider Newsletter - Ohio Medicare Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

April 2019 Anthem Provider Newsletter - Ohio Administrative Apr 1, 2019

When and how to initiate Medicare Advantage reopenings

December 2018 Anthem Ohio Provider Newsletter Medicare Dec 1, 2018

What Matters Most: Improving the patient experience

October 2020 Anthem Provider News - Ohio Administrative Oct 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News - Ohio Administrative Jul 1, 2020

Webinar recording now available for providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Ohio Behavioral Health Jun 25, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Ohio Administrative May 1, 2020

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

August 2020 Anthem Provider News - Ohio Pharmacy Aug 1, 2020

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators Administrative Jun 25, 2021

View reimbursement policies online at anthem.com

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

View reimbursement policies online at anthem.com

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Verifying and updating your provider information

December 2019 Anthem Provider News - Ohio Administrative Dec 1, 2019

Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web

December 2018 Anthem Ohio Provider Newsletter Administrative Dec 1, 2018

Utilization management authorization rule operations

September 2021 Anthem Provider News - Ohio Medicare Sep 1, 2021

Use grouped CPT codes for AIM Specialty Health authorizations

February 2019 Anthem Ohio Provider Newsletter Medicare Feb 1, 2019

US Antibiotic Awareness Week is November 11-18, 2019

October 2019 Anthem Provider News - Ohio Federal Employee Plan (FEP) Oct 1, 2019

US Antibiotic Awareness Week

November 2020 Anthem Provider News - Ohio Administrative Nov 1, 2020

Updates to AIM Spine Surgery Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Ohio Medicare Jun 1, 2020

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

August 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Radiation Oncology clinical appropriateness guideline*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines

December 2018 Anthem Ohio Provider Newsletter Coverage and Clinical Guidelines Dec 1, 2018

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM musculoskeletal program clinical appropriateness guidelines*

*Notice of Material Amendment/Change to Contract (MAC)
June 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

February 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Ohio Medicare Jan 1, 2021

Updates to AIM Cardiology clinical appropriateness guidelines*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

August 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

July 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jul 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

August 2019 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM advanced imaging clinical appropriateness guidelines*

*Notice of Material Amendment/Change to Contract (MAC)
June 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

February 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM Advanced Imaging clinical appropriateness guideline*

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2020

Updates for specialty pharmacy are available - September 2021*

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Pharmacy Sep 1, 2021

Updates for specialty pharmacy are available - May 2021*

*Notice of Material Amendment/Change to Contract (MAC)
May 2021 Anthem Provider News - Ohio Pharmacy May 1, 2021

Updates for specialty pharmacy are available - March 2021*

*Material Adverse Change (MAC)
March 2021 Anthem Provider News - Ohio Pharmacy Mar 1, 2021

Updates for specialty pharmacy are available - June 2021*

*Notice of Material Amendment/Change to Contract (MAC)
June 2021 Anthem Provider News - Ohio Pharmacy Jun 1, 2021

Updates for specialty pharmacy are available - July 2021*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Pharmacy Jul 1, 2021

Updates for specialty pharmacy are available - August 2021*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Pharmacy Aug 1, 2021

Updates for specialty pharmacy are available - April 2021*

*Notice of Material Amendment/Change to Contract (MAC)
April 2021 Anthem Provider News - Ohio Pharmacy Apr 1, 2021

Updated Provider Manual posted to anthem.com

October 2018 Anthem Ohio Provider Newsletter Administrative Sep 28, 2018

Updated Provider Manual now available*

October 2020 Anthem Provider News - Ohio Administrative Oct 1, 2020

Updated Provider Manual now available

April 2021 Anthem Provider News - Ohio Administrative Apr 1, 2021

Updated COVID-19 Medicare Information

For the latest COVID-19 Medicare information, please check Medicare Advantage Provider News Archives.
COVID-19 Information - Ohio Medicare Mar 25, 2020

Updated coverage for HIV PrEP medications

July 2020 Anthem Provider News - Ohio Pharmacy Jul 1, 2020

Updated coverage for breast cancer prevention medications

October 2020 Anthem Provider News - Ohio Pharmacy Oct 1, 2020

Updated BlueCard® Provider Manual available

December 2020 Anthem Provider News - Ohio Administrative Dec 1, 2020

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews*

*Notice of Material Amendment/Change to Contract (MAC)
May 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2021

Update: Site of care medical necessity reviews for long-acting colony-stimulating factors not implemented on June 1, 2021*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Pharmacy Jul 1, 2021

Update: Sepsis Coding

August 2019 Anthem Provider News - Ohio Administrative Aug 1, 2019

Update: Notice of changes to the AIM Small Joint Surgery guideline

March 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Mar 1, 2021

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements*

April 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Apr 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

July 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jul 1, 2020

Update: Notice of changes to the AIM musculoskeletal program

September 2020 Anthem Provider News - Ohio Medicare Sep 1, 2020

UPDATE: New Rehabilitative Program remains temporarily delayed

Anthem Ohio UPDATE: New Rehabilitative Program remains temporarily delayed Products & Programs Jul 16, 2019

UPDATE: new Rehabilitative Program now effective August 1, 2019

Anthem Ohio UPDATE: new Rehabilitative Program now effective August 1, 2019 Products & Programs Jul 3, 2019

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News - Ohio Products & Programs Jun 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

July 2020 Anthem Provider News - Ohio Products & Programs Jul 1, 2020

UPDATE: new AIM Rehabilitative Program will begin November 1, 2019

October 2019 Anthem Provider News - Ohio Products & Programs Oct 1, 2019

Update: Drug Screen Testing - Professional*

May 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies May 1, 2019

Update: Clinical guideline adoption postponed*

*Notice of Material Amendment/Change to Contract (MAC)
April 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Apr 1, 2021

Update: AIM Musculoskeletal Program effective November 1, 2021 - Site of care reviews*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2021

Update: 2019 risk adjustment provider trainings

October 2019 Anthem Provider News - Ohio Medicare Oct 1, 2019

Update to Provider UM reimbursement penalties and corresponding update to Provider Manual*

July 2019 Anthem Provider News - Ohio Administrative Jul 1, 2019

Update to evaluation and management services correct coding - Professional

June 2021 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2021

Update to Durable Medical Equipment - effective October 14, 2018

October 2018 Anthem Ohio Provider Newsletter Administrative Oct 12, 2018

Update to AIM Specialty Health sleep disorder management clinical appropriateness guidelines

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Specialty Health radiation oncology clinical appropriateness guidelines

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

May 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines May 1, 2021

Update to AIM Specialty Health clinical appropriateness guidelines

October 2018 Anthem Ohio Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines*

April 2019 Anthem Provider Newsletter - Ohio Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

February 2019 Anthem Ohio Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Update to AIM Musculoskeletal Joint Surgery Clinical Appropriateness Guidelines*

April 2019 Anthem Provider Newsletter - Ohio Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Clinical Appropriateness Guidelines

December 2018 Anthem Ohio Provider Newsletter Coverage and Clinical Guidelines Dec 1, 2018

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline*

April 2019 Anthem Provider Newsletter - Ohio Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines*

April 2019 Anthem Provider Newsletter - Ohio Medical Policy & Clinical Guidelines Apr 1, 2019

Update regarding evaluation and management with modifier 25

April 2019 Anthem Provider Newsletter - Ohio Medicare Apr 1, 2019

Update regarding E/M with modifier 25 - Professional*

February 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Feb 1, 2019

Update regarding drugs not approved by the FDA

January 2019 Anthem Ohio Provider Newsletter Pharmacy Jan 1, 2019

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

April 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Apr 1, 2021

Upcoming Changes for Automotive Accounts

December 2018 Anthem Ohio Provider Newsletter Products & Programs Dec 1, 2018

Understanding Availity roles for electronic data interchange (EDI)

April 2021 Anthem Provider News - Ohio Administrative Apr 1, 2021

UM Process Change: Courtesy approval determination notifications

April 2019 Anthem Provider Newsletter - Ohio Administrative Apr 1, 2019

Two great learning resources on one secure portal

June 2021 Anthem Provider News - Ohio Digital Tools Jun 1, 2021

Trusted Senior Care Advantage - a delegated provider for southeastern Ohio Medicare Advantage membership

April 2020 Anthem Provider News - Ohio Medicare Apr 1, 2020

Transition to AIM Specialty Health imaging of the heart clinical appropriateness guideline for computed tomography to detect coronary artery calcification

August 2021 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Aug 1, 2021

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines*

June 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Jun 1, 2020

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

December 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Dec 1, 2020

Transition to AIM rehabilitative service clinical appropriateness guidelines

October 2020 Anthem Provider News - Ohio Medical Policy & Clinical Guidelines Oct 1, 2020

Tips for billing CPT modifier 33

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claims

July 2021 Anthem Provider News - Ohio Administrative Jul 1, 2021

The New Year brings New ID Cards for many Anthem members

January 2020 Anthem Provider News - Ohio Administrative Jan 1, 2020

The health of millennials: Trends in behavioral health conditions

April 2021 Anthem Provider News - Ohio Behavioral Health Apr 1, 2021
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